Page 58 - 21st Century Perspective - Glaucoma Supplement

This unique secondary glaucoma is called ​pseudoexfoliation​ because true lens capsular exfoliation
is seen mostly in two occupations — glassblowers and iron industry workers. Since this entity looks
similar to that of true exfoliation, it is called ​pseudoexfoliation​.

Pseudoexfoliation glaucoma ​(Figure 30)​ is a bilateral (although it can be rather asymmetric),
lenticular capsular abnormality seen most commonly in people older than age 70. Unilateral
exfoliation is almost always a precursor of bilateral disease.

● The subset of glaucoma patients with pseudoexfoliation is approximately 5% to 10%.
● It is not associated with any known systemic disease. There is no known genetic influence.
● Small, whitish flakes in the pupillary region of the lens face are commonly seen even before
dilation; however, the dilated view of the anterior lens capsule is classic.
● As in pigment dispersion, there is pigmentation of the trabecular meshwork; however,

exfoliative
● debris is less distinct than the melanin pigmentation seen in pigment dispersion. This
exfoliative pigmentation band is referred to as Sampaolesi’s line.
● Increased IOP is seen in most patients with pseudoexfoliation. As with all the glaucomas, if
the IOP is high enough long enough, then glaucoma can result.

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